Imperial College Healthcare NHS Trust will provide a verbal update about the delayed rebuilding of St Mary's Hospital and the impact on residents.
Minutes:
Dr Bob Klaber (Director of Strategy, Research and Innovation, Imperial College Healthcare NHS Trust) addressed the Committee and provided a verbal update about the delayed rebuilding of Charing Cross, Hammersmith, and St Mary's Hospitals and the healthcare impacts on residents.
A series of photographs showing run-down areas of St Mary’s Hospital were distributed in the meeting.
Dr Klaber told the Committee that St Mary’s Hospital currently had one ward closed and said there were constant issues across the estate making things difficult for staff and patients. The New Hospital Programme recently announced they were delaying funding for the rebuild beyond 2030, although he noted they had promised funding for a business case for the eventual rebuild.
Dr Klaber said he felt there were opportunities to move further up the list, using a combination of public money and some commercial money from land sales. The Trust calculated they needed around 40% percent of the land for the hospital. He added that Charing Cross and Hammersmith Hospitals could be rebuilt in phases, building on some of the existing good quality infrastructure and replacing the poor infrastructure.
Councillor Amanda Lloyd-Harris noted the refurbishment of Charing Cross was being delayed and asked, if groundwork started in 2024, what the completion date would be. Dr Klaber said he couldn’t give an estimate. He noted the business plan was due to be submitted in the autumn. He added that Charing Cross would be a phased rebuild. The business plan would explore how best to deliver that phasing. He said the clear steer from the programme had been that there was potential to have a significant funding envelope brought forward and the trust was doing everything they could to bring it forward. He hoped that could be done in partnership with local authorities.
Councillor Lloyd-Harris said engaging with commercial enterprises was often contentious locally and asked how the Trust planned to deal with that, and what benefits there might be for patients and staff. Dr Klaber said he understood that some people may have anxieties, but by starting with communities and population need, they were much more likely to get to the right answer. He said it was clear that there were ways to do it to create some competition in an open way, to give taxpayers confidence they were getting value for money. He said, things that kicked it into the long grass would make things worse for patients and ultimately cost more money.
Jim Grealy asked if the deteriorating condition of one of the three hospitals could have wider consequences, pushing services to other places. He also asked what the effects of delaying the necessary rebuild would have on care. Dr Klaber said the current state of the buildings was difficult for staff who wanted to deliver the highest quality care, as well as being difficult for patients. He said the impact of estate failure could have knock-on effects in all sorts of spaces. Running services at very high capacities had serious impacts. He said the Trust and its partners needed to work together as a system, to understand patient need – both current and future need – and think about how to run the highest quality systems.
Merril Hammer asked for clarification that Imperial initially understood it would be given money for St Marys, Hammersmith, and Charing Cross Hospitals to complete works before 2030. Dr Klaber said yes, they were part of the initial programme, but there was no specific money attached.
Merril Hammer asked for confirmation that no clear date had yet been given for funding to be given or building works to be completed. Dr Klaber said work and planning around St Mary’s hadn’t stopped. The Trust was doing everything it could to progress the rebuild. Regarding funding, they had been told it would come after 2030.
Merril Hammer asked for reassurances that Imperial were not considering a Private Finance Initiative (PFI). Dr Klaber said strong financial management was a key part of delivering good care and was important to the Trust. He said the Committee could have confidence that they wouldn’t agree to any scheme that would simply defer the financial problem. He said they were trying to be creative and open minded.
Councillor Ben Coleman (Deputy Leader and Cabinet Member for Health and Social Care) asked if the Trust expected to sell enough land on the St Mary’s site to get all money needed for the rebuild.Dr Klaber said roughly 40% of the land was needed for a hospital but funding from land sales depended on density, build height etc. He said the relationship with Westminster City Council had been very productive, but it was not a ‘done deal’.
Councillor Coleman asked for clarification that if the business plan was completed early, then there was a possibility that Charing Cross and Hammersmith Hospitals might move up the list. Dr Klaber said yes, he believed they could get funding for the refurbishment of certain buildings but it was complex and required the right plans. Councillor Coleman commented that the plans seemed highly contingent.
Councillor Coleman asked what impact the worsening estate at St Mary’s would have on Charing Cross and other nearby hospitals. Dr Klaber said the estates team could plan to an extent, but it depended on the services affected. Despite excellent work done to keep services running during recent disruptions, there was a limit because of a lack of spare capacity.
Victoria Brignell suggested the Trust could approach rich philanthropists for contributions to the rebuild.Dr Klaber said they were open-minded, and philanthropy was something they were exploring – particularly in relation to research.
Jim Grealy asked if the state of the buildings at St Mary’s and other sites meant innovations and improvements to the patient experience were being postponed. Dr Klaber said it went both ways. The state of the facilities had driven innovation in some areas like ‘hospital at home’, virtual wards, and a more integrated approach. He noted that in other areas such as research it was not practical to realise their vision of research at every bedside. He added that estate failures meant it was difficult to think in a forward looking way and it was frustrating for the organisation and staff to spend so much time dealing with problems.
The Chair thanked Dr Klaber for attending and providing an update. She highlighted the concerns that residents had over the delays, the importance of hospitals that were fit for purpose and met the needs of patients and the community, and the importance of partnership working.
Councillor Coleman noted that the ICB had commissioned a piece of work looking at the impact on patients and said he looked forward to seeing the report and understanding the impact in more detail.